Post on 14-Jul-2015
Many people state that technology sometime add costs instead of saving it..
2
Wouter Bos (last year) Technology sometime add costs instead of saving it
Director care procurement: “eHealth is not cost effective” “we have invested a lot in quit smoking programs, but don’t see the savings”
Pitfalls in technological innovations causes costs increase instead of the expected decline
3
Better specifications… no added value
Technology as add on to existing process
‘Free capacity’ not withdrawn from the system
+ Hospital
Cardiologist
Nurses
“free resource”
Pitfalls in technological innovations causes costs increase instead of the expected decline
4
Better specifications… no added value
Technology as add on to existing process
‘Free capacity’ not withdrawn from the system
+ Hospital
Cardiologist
Nurses
“free resource”
Technology is often used as an add to an existing process rather than facilitate process changes
5
+
In many cases blended care is not a redesign but an extra on the current process
EHealth depression
advice
Check up
Reworked diabetes management process is Using eHealth as an enabler
+
Don’t add on technology! Use it to enable better processes
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+ advice
Check up
No more technology as add on
Use technology as an enabler for processes optimalisation
Health care professionals Learn to use technology as an enabler Learn BPR Dare to question the current process and experiment Don’t add on!
Technology providers Stop pushing technology, start facilitating better processes Dare to question the use of your product Don’t add on
Don’t add on… create better processes
Using BPR instead of add on….. We created a sustainable gamified autism treatment
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Kosten'emodule
%'tijdsbesparing
Psychiater GZ:psycholoog SPH'''''''''''''''''''''Kosten' Opbrengst
Uren tarief Uren Tarief Uren Tarief
Eerste&doorrekening 0 0 0,5 €&87 2 €&214 5,75 €&483 €&784 €&711*&Toevoegen&kosten&emodule&*&Verlagen&SPH&uren 50 0 0,5 €&87 2 €&214 5 €&420 €&771 €&2*&Toevoegen&kosten&emodule&*&Verlagen&SPH&uren& 75 0 0,5 €&87 2 €&214 4,75 €&399 €&775 €&72*&Toevoegen&kosten&emodule&*&Verlagen&SPH&en&GZ7psycholoog&uren& 100 0 0,5 €&87 1,75 €&187 4,5 €&378 €&752 €&21*&Toevoegen&kosten&emodule&*&Verlagen&SPH&en&GZ&uren&&&&&&&&&*&%&tijdsbesparing&toevoegen 50 10 0,5 €&87 1,5 €&161 4,75 €&399 €&697 €&71*&Toevoegen&kosten&emodule&*&Verlagen&SPH&en&GZ&uren&&&&&&&&&*&%&tijdsbesparing&toevoegen 75 10 0,5 €&87 1,5 €&161 4,25 €&357 €&680 €&16*&Toevoegen&kosten&emodule&*&Verlagen&SPH&en&GZ&uren&&&&&&&&&*&%&tijdsbesparing&toevoegen 100 10 0,5 €&87 1,25 €&134 4,25 €&357 €&678 €&18
Current process: They analysed the time saved per care provider by using EHealth
€ 800 per treatment
BPR process: Client goals central Ehealth and group support Professional as coach
€ 400 per treatment
Current process: € 750
Pitfalls in technological innovations causes costs increase instead of the expected decline
8
Better specifications… no added value
Technology as add on to existing process
‘Free capacity’ not withdrawn from the system
+ Hospital
Cardiologist
Nurses
“free resource”
In many cases the costs per unit decreases but …. increases the total costs
9
Costs per unit decreases…
&
Total cost increases
Before After technological innovation
Before After technological innovation
Heart failure case
10
New process for heart failure using tele monitoring
In 5 hospitals the process for heart failure treatment were redesigned using tele monitoring
50% less hospital admissions 50% less exurcebations 8 patient satisfaction 20% reduction in professional time 25% reduction in fee cardiologist 40% reduction in revenue hospital € 83 mln. potential cost reduction
Great results…
A technology based redesigned process should require less professional time
11
Hospital
Cardiologist
Nurses
Implementation of new Heart failure processes would free up resources
A technology based redesigned process should require less professional time
12
Hospital
Cardiologist
Nurses
“free resource”
Implementation of new Heart failure process would free up resources
The “free resources” are used to treat new patients and hence the total costs will rise
13
Hospital
Cardiologist
Nurses
“free resource”
Implementation of new Heart failure process would free up resources
If the ‘free resources’ are not withdrawn from the system they tend to find a new function… - Lower intervention boundaries - New patient groups - New treatment If the ‘free resources’ find new treatment (revenue) the total costs for the healthcare system rises!
The challenge of the “free resources” is faced by all innovation projects
14
Hospital
Cardiologist
Nurses
“free resource”
vv Blended care
3 Face tot Face + an ehealth
program
Or
F2F + tel support + eHealth
Cost: € 400 - € 500
g Depression treatment in current situation
1st line: 8 consultations
€ 640
2e line: 8-12 consultation
€ 1200
Reductie 50%
+
Same outcome
advice
Check up
Your innovation
Innovative heart failure treament
Blended depression care
Blended diabetes care
Reduction 60%
How to withdraw the ‘free resources’ from the healthcare system?
15
Hospital
Cardiologist
Nurses
“free resource”
Hospital Less revenue, more profit Compensation for creative destruction costs Professionals Fixed capacity: compensated for revenue loss Variable capacity: step by step transferred to other areas Overhead: reduced Insurer Lower prices
No financial instrument available…
Let’s finance creative destruction!
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Hospital
Cardiologist
Nurses
“free resource” Health
Insurer
Creative Destruction
Fund
Less revenue, more profit Lower prices (incl. deprecation) Profit protection
Contract
Finances: - The innovation - The Creative destruction
cost
Care provider
We will start a creative destruction! fund
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Hospital
Cardiologist
Nurses
“free resource” Health
Insurer
Creative REconstruction
Fund
Less revenue, more profit Lower prices (incl. deprecation) Profit protection
Contract
Finances: - The innovation - The Creative
REconstruction cost
Care provider
Imagine … if we together would reconstruct..
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Let creative destruction…. Labs ….. From 400 to.. Saves ?? Derma … Heartfailure.. Diabetes Depression A solution to our
Healthcare cost problem
Hospital
Cardiologist
Nurses
“free resource” Health
Insurer
Creative Destruction
Fund
Less revenu, more profit Lower prices (incl deprecation) Profit protection
Contract
Finances: - The innovation - The Creative destruction
cost
Care provider
It doesn’t only take a financial instrument… we need cooperation, vision and a lot of courage too..
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Scaling up innovation
Co operation to jointly tackle big problems instead of power games Vision of how WE want OUR healthcare to be instead of finding arguments to defend your own positions Courage to choose the hard path to find a solution and face our own colleagues Instead of ‘to indulge the hostility’